If you live with diabetes and have elevated blood glucose levels, you may also have high cholesterol.

But how exactly is glucose metabolism impacted by cholesterol? And does diabetes impact cholesterol levels?

This article will explore how glucose metabolism impacts cholesterol, whether diabetes and higher blood sugars impact cholesterol levels, and what impact cholesterol levels may have on diabetes management.

According to the American Heart Association, cholesterol is a waxy substance found in the blood that is crucial for cell building and making vitamins for the body to function.

Cholesterol can come from either of two sources: the liver or food. Most animal products, including poultry, meat, eggs, and dairy products, contain dietary cholesterol. But too much can come with health risks.

3 components of cholesterol

There are 3 parts of cholesterol that you get checked:

  • Low-density-lipoprotein (LDL): This is commonly known as “bad” cholesterol. When levels of this type of cholesterol are too high, arteries become narrowed or clogged, which can lead to heart disease, stroke, or heart attacks.
  • High-density-lipoprotein (HDL): This is commonly known as “good” cholesterol. If you have low levels of HDL cholesterol, you could be at risk for heart disease and other health issues, especially if you also have high LDL cholesterol.
  • Triglycerides: These are derived from fats in food. They are stored directly as fat cells. While not technically cholesterol, they are measured along with LDL and HDL to get a fuller picture of your overall health. Measuring triglycerides can also help determine your risk of developing atherosclerosis, or the buildup of fatty deposits in the artery walls, which puts you at risk for heart disease and stroke.
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Glucose metabolism is the biochemical process responsible for the breakdown and interconversion of glucose and carbohydrates in humans.

Carbohydrates are crucial for humans and a key component of metabolic pathways to sustain life. When people have diabetes, their bodies can’t either metabolize glucose completely (in the case of type 1 diabetes) or properly metabolize glucose fully (in the case of prediabetes, gestational, or type 2 diabetes).

Cholesterol levels and glucose metabolism are closely related. Having elevated blood glucose levels (any type of diabetes) poses a risk of higher cholesterol, manifesting as diabetic dyslipidemia.

Diabetic dyslipidemia occurs when someone has diabetes along with elevated triglycerides, low HDL levels, and high LDL levels. Up to 70% of people with type 2 diabetes have diabetic dyslipidemia.

Alternatively, high cholesterol levels put you at increased risk for prediabetes and type 2 diabetes. High triglycerides and low HDL levels are not only a consequence of high blood sugars but are also a cause.

Also, when people already have diabetes and start taking statins for high cholesterol, they often have difficulty with blood sugar management.

Elevated glucose levels — or impaired glucose metabolism — does raise cholesterol levels.

One reason is that people with diabetes tend to have smaller and denser LDL particles than people without diabetes.

Smaller and denser LDL particles allow cholesterol to get into blood vessel walls more easily, plaquing arteries and leading to high cholesterol levels. It compounds the risk for heart disease and stroke because people with diabetes are already at elevated risk of developing these conditions.

Obesity is also tied to cholesterol.

Although type 2 diabetes is not always caused by or associated with obesity, research from 2016 shows that 85% of people with type 2 diabetes have overweight or obesity. These weight levels raise the risk of developing higher cholesterol, and in turn, obesity does increase the likelihood of type 2 diabetes.

Also, the chance of higher cholesterol is higher for people who live with type 1 diabetes.

There are several ways to lower cholesterol and blood glucose levels.

Increasing physical activity

Exercising, even just 10 to 30 minutes a day, can lower “bad” LDL cholesterol and raise “good” HDL cholesterol. Exercising can also lower blood sugar levels. Studies from 2015 show that increasing HDL cholesterol is statistically significant in helping lower blood glucose levels in people with type 2 diabetes.

The Centers for Disease Control and Prevention (CDC) recommends at least 150 minutes of moderate activity a week, or about 30 minutes a day, 5 days of the week.

Even if you can’t exercise for the recommended amount of time per day, maintaining a moderate weight may help prevent high cholesterol levels to an extent and ward off prediabetes and type 2 diabetes. According to the Obesity Action Coalition, shedding just 5% to 10% of your body weight can significantly reduce cholesterol levels.

Changing your eating habits

Several suggestions can help you lower cholesterol levels.

  • Try avoiding foods with lots of saturated fats. These may include cheese, fatty meats, egg yolks, and full-fat dairy products. For example, try lowering the percentage of milk you drink. The American Heart Association recommends limiting your consumption of saturated fats to less than 5% or 6% of your daily calorie intake.
  • Be sure to include lots of healthy fats into your meal planning, such as those found in nuts, fish, and extra virgin olive oil. Also include lots of fresh fruits, vegetables, legumes, and beans into your meal plans.
  • Edamame is a popular soybean with vegetarians. The immature soybean contains isoflavones, which can lower cholesterol levels.
  • Another cholesterol inhibiting nutrient is lycopene, found in tomatoes. Eating a diet rich in fruits and vegetables will also make diabetes management much easier and will lower blood sugars.

Exercising and changing eating habits can lead to weight loss. Reducing or preventing obesity lessens your risk for prediabetes, type 2 diabetes, and high cholesterol.

If you smoke, consider stopping

Smoking cessation lowers cholesterol levels. Smoking is a major risk factor for high cholesterol. It also makes diabetes management much more difficult.

Medications to lower cholesterol

If lifestyle changes are not lowering your cholesterol, you may need to take medications, such as:

  • Statins: This class of medications may help lower cholesterol levels and these are the frontline treatment for people with type 1 and type 2 diabetes.
  • Cholesterol absorption inhibitors: This medication treats high cholesterol in people who cannot take a statin. It lowers total cholesterol and LDL (bad) cholesterol levels, and it’s used along with lifestyle changes such as diet and exercise.
  • Bile acid sequestrants: These medications prevent bile acid in your stomach from being absorbed into your blood. Your liver then needs the cholesterol from your blood to make more bile acid. This reduces your cholesterol level.
  • Fibric acid: This medication is helpful particularly for high triglycerides.
  • Omega 3-fatty acid: There is strong evidence that this helps lower cholesterol.

Talk with your doctor about the most appropriate course of action if you have high cholesterol.

If you have high blood sugar levels and lifestyle changes are not enough to lower them, talk with your doctor about your options and potentially starting treatment with any of the following diabetes medications:

  • metformin
  • insulin
  • SGLT2 inhibitor
  • GLP-1 inhibitor

Cholesterol and glucose metabolism impact each other. They also both play roles in diabetes management, and higher glucose readings or cholesterol levels have a negative effect on the other.

If have both high cholesterol and diabetes, it’s crucial to get treatment for both conditions. This will reduce your risk of developing heart disease and other complications as you age.